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General NPI Number Information
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NPI Number | 1023778578
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Entity Type | Individual
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Provider Name | RIVA TARIKA WALKER DDS
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Gender | Female
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Dates
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Enumeration Date | 12/26/2021
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Last Update Date | 01/19/2022
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Provider Practice Location Address
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Address Line | 100 HARDEMAN BLVD
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City | JUSTIN
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State | TX
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Zip | 76247-7064
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Country | US
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Telephone | 940-278-0909
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Fax |
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Provider Business Mailing Address
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Address Line | 307 RIDGEWOOD DR
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City | LEWISVILLE
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State | TX
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Zip | 75067-8244
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Country | US
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Telephone | 908-283-1672
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 38009
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License Number State | TX
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